Longabaugh Richard
Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02903, USA.
Alcohol Clin Exp Res. 2007 Oct;31(10 Suppl):21s-32s. doi: 10.1111/j.1530-0277.2007.00490.x.
Definitive results from efforts to identify mechanisms of change in behavioral treatments for alcohol use disorders have been elusive. The working hypothesis guiding this paper is that one of the reasons for this elusiveness is that the models we hypothesize to account for treatments effectiveness are unnecessarily restricted and too simple.
This paper aims to accomplish 3 things. First, a typography for locating potential mediators of change will be presented. In the course of doing so, a nomenclature will be proposed with the hope that this will facilitate communications among alcohol treatment researchers studying mechanisms of change. Second, alternatives to the classic test of mediation of alcohol treatment effects will be considered and one such alternative described. Third, alternative ways of conceptualizing, constructing and analyzing variables to measure mediators will be suggested.
It is hoped that this commentary will facilitate research on mechanisms of change in behavioral treatments for alcohol use disorders.
Behavioral change is a complex process, and the models that we develop to account for this process need to reflect this complexity. Advances in statistical approaches for testing mediation, along with a better understanding as to how to use these tools should help in moving toward this goal.
确定酒精使用障碍行为治疗中变化机制的努力所得到的确切结果一直难以捉摸。指导本文的工作假设是，这种难以捉摸的原因之一是我们假设用于解释治疗效果的模型受到不必要的限制且过于简单。
本文旨在完成三件事。首先，将介绍一种定位潜在变化中介因素的方法。在此过程中，将提出一种命名法，希望这将促进研究酒精治疗变化机制的研究人员之间的交流。其次，将考虑对酒精治疗效果中介经典测试的替代方法，并描述其中一种替代方法。第三，将提出概念化、构建和分析用于测量中介因素变量的替代方法。
希望本评论将促进对酒精使用障碍行为治疗变化机制的研究。
行为改变是一个复杂的过程，我们为解释这一过程而开发的模型需要反映这种复杂性。测试中介作用的统计方法的进展，以及对如何使用这些工具的更好理解，应有助于朝着这一目标迈进。
